-
Brain Sciences Mar 2023Virtual reality (VR) has emerged as a safe and non-invasive technology for the assessment of psychotic symptoms, social and cognitive impairments, and psychosocial... (Review)
Review
Virtual reality (VR) has emerged as a safe and non-invasive technology for the assessment of psychotic symptoms, social and cognitive impairments, and psychosocial intervention in improving outcomes in psychosis. This study systematically reviewed the current state of evidence in applying semi- and fully immersive VR for assessing and treating patients with psychosis. A systematic review was conducted adhering to the PRISMA statement and was conducted in Embase, PsycINFO, and PubMed databases for articles published between January 2013 and April 2022, which identified 28 eligible studies, including 12 for assessment and 16 for intervention. In the assessment studies, not all VR tasks could distinguish the differences between patients and healthy controls regarding their physiological responses, paranoid ideation, and certain aspects of cognitive functioning such as memory bias on the object tasks. Comparatively, VR-based interventions are more promising, especially for improving cognitive impairments, social skills, agoraphobic avoidance, negative and positive affective states, auditory verbal hallucination, paranoid ideation and persecutory delusions, and other psychiatric symptoms in patients. We conclude that more rigorous studies are needed to confirm treatment effectiveness and to understand the underlying mechanism of VR-based intervention for psychotic disorders. Future studies should also improve the reliability and validity of VR-based assessments for psychotic disorders.
PubMed: 36979281
DOI: 10.3390/brainsci13030471 -
Nurse Education Today Jan 2021To identify and synthesise data from studies that have evaluated the outcomes of voice hearing simulation as an educational intervention with health care professionals... (Review)
Review
OBJECTIVES
To identify and synthesise data from studies that have evaluated the outcomes of voice hearing simulation as an educational intervention with health care professionals and those in training.
DESIGN
The research employed a systematic review that was informed by Centre for Reviews and Dissemination DATA SOURCES: The databases Web of Science, Medline, Embase, PsycINFO, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials Register and CINAHL were systematically searched to January 2020.
REVIEW METHODS
Identified studies were screened by title (n = 509), abstract (n = 246) and full text (n = 56) using the following inclusion criteria: studies employing either qualitative and/or quantitative research methods, which have evaluated voice hearing simulation as a principal educational intervention with health care professionals during training or post-qualification.
RESULTS
Twenty six studies were included in the review. Eleven studies adopted mixed methods, five adopted quantitative methods and ten used qualitative methods. Although most of the studies were of low to medium quality the findings were encouraging and suggest that voice hearing simulation may be a useful educational intervention. Positive outcomes of simulation included improvements in empathy, attitudes, knowledge, understanding about voice hearing experiences and increased confidence in practice. The majority of participants that took part in voice hearing simulation thought that it was a powerful learning experience that should be offered to other health care professionals and those in training.
CONCLUSIONS
Voice hearing simulation is a valuable educational intervention that should be routinely used by academics when teaching health professionals and those in training about the experiences of people who hear voices. However, to confirm its true effects and optimum mode of delivery further better quality research is needed.
Topics: Delivery of Health Care; Health Personnel; Hearing; Humans; Learning
PubMed: 33157364
DOI: 10.1016/j.nedt.2020.104626 -
Clinical Toxicology (Philadelphia, Pa.) 2016Synthetic cannabinoids (SCs) such as "Spice", "K2", etc. are widely available via the internet despite increasing legal restrictions. Currently, the prevalence of use is... (Review)
Review
CONTEXT
Synthetic cannabinoids (SCs) such as "Spice", "K2", etc. are widely available via the internet despite increasing legal restrictions. Currently, the prevalence of use is typically low in the general community (<1%) although it is higher among students and some niche groups subject to drug testing. Early evidence suggests that adverse outcomes associated with the use of SCs may be more prevalent and severe than those arising from cannabis consumption.
OBJECTIVES
To identify systematically the scientific reports of adverse events associated with the consumption of SCs in the medical literature and poison centre data.
METHOD
We searched online databases (Medline, PsycInfo, Embase, Google Scholar and Pubmed) and manually searched reference lists up to December 2014. To be eligible for inclusion, data had to be from hospital, emergency department, drug rehabilitation services or poison centre records of adverse events involving SCs and included both self-reported and/or analytically confirmed consumption.
RESULTS
From 256 reports, we identified 106 eligible studies including 37 conference abstracts on about 4000 cases involving at least 26 deaths. Major complications include cardiovascular events (myocardial infarction, ischemic stroke and emboli), acute kidney injury (AKI), generalized tonic-clonic seizures, psychiatric presentations (including first episode psychosis, paranoia, self-harm/suicide ideation) and hyperemesis. However, most presentations were not serious, typically involved young males with tachycardia (≈ 37-77%), agitation (≈ 16-41%) and nausea (≈ 13-94%) requiring only symptomatic care with a length of stay of less than 8 hours.
CONCLUSIONS
SCs most frequently result in tachycardia, agitation and nausea. These symptoms typically resolve with symptomatic care, including intravenous fluids, benzodiazepines and anti-emetics, and may not require inpatient care. Severe adverse events (stroke, seizure, myocardial infarction, rhabdomyolysis, AKI, psychosis and hyperemesis) and associated deaths manifest less commonly. Precise estimates of their incidence are difficult to calculate due to the lack of widely available, rapid laboratory confirmation, the variety of SC compounds and the unknown number of exposed individuals. Long-term consequences of SCs use are currently unknown.
Topics: Cannabinoids; Drug Overdose; Humans; Marijuana Abuse; Marijuana Smoking; Prognosis; Psychotropic Drugs; Risk Factors; Substance Abuse Detection; Time Factors
PubMed: 26567470
DOI: 10.3109/15563650.2015.1110590 -
World Psychiatry : Official Journal of... Feb 2021Experiencing psychological trauma during childhood and/or adolescence is associated with an increased risk of psychosis in adulthood. However, we lack a clear knowledge...
Experiencing psychological trauma during childhood and/or adolescence is associated with an increased risk of psychosis in adulthood. However, we lack a clear knowledge of how developmental trauma induces vulnerability to psychotic symptoms. Understanding the psychological processes involved in this association is crucial to the development of preventive interventions and improved treatments. We sought to systematically review the literature and combine findings using meta-analytic techniques to establish the potential roles of psychological processes in the associations between developmental trauma and specific psychotic experiences (i.e., hallucinations, delusions and paranoia). Twenty-two studies met our inclusion criteria. We found mediating roles of dissociation, emotional dysregulation and post-traumatic stress disorder (PTSD) symptoms (avoidance, numbing and hyperarousal) between developmental trauma and hallucinations. There was also evidence of a mediating role of negative schemata, i.e. mental constructs of meanings, between developmental trauma and delusions as well as paranoia. Many studies to date have been of poor quality, and the field is limited by mostly cross-sectional research. Our findings suggest that there may be distinct psy-chological pathways from developmental trauma to psychotic phenomena in adulthood. Clinicians should carefully ask people with psychosis about their history of developmental trauma, and screen patients with such a history for dissociation, emotional dysregulation and PTSD symptoms. Well conducted research with prospective designs, including neurocognitive assessment, is required in order to fully understand the biopsychosocial mechanisms underlying the association between developmental trauma and psychosis.
PubMed: 33432756
DOI: 10.1002/wps.20841 -
European Journal of Psychotraumatology 2020: Psychosis is a public health concern. There is increasing evidence suggesting trauma can play a pivotal role in the development and maintenance of psychosis. Eye... (Review)
Review
: Psychosis is a public health concern. There is increasing evidence suggesting trauma can play a pivotal role in the development and maintenance of psychosis. Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for trauma and could be a vital addition to the treatment of psychosis. : To explore the evidence for EMDR as a treatment for psychosis, focussing on the safety, effectiveness and acceptability of this intervention for this population. : Four databases (Cochrane, EMBASE, MEDLINE PsychINFO), and the Francine Shapiro Library were systematically searched, along with grey literature and reference lists of relevant papers. No date limits were applied as this is an area of emerging evidence. Studies were screened for eligibility based on inclusion and exclusion criteria. The included studies were quality assessed and data was extracted from the individual studies, and synthesized using a narrative synthesis approach. : Six studies met the inclusion criteria (1 RCT, 2 Pilot studies, 2 Case series and 1 Case report). Across the studies EMDR was associated with reductions in delusional and negative symptoms, mental health service and medication use. Evidence for reductions in auditory hallucinations and paranoid thinking was mixed. No adverse events were reported, although initial increases in psychotic symptoms were observed in two studies. Average dropout rates across the studies were comparable to other trauma-focused treatments for PTSD. The acceptability of EMDR was not adequately measured or reported. : EMDR appears a safe and feasible intervention for people with psychosis. The evidence is currently insufficient to determine the effectiveness and acceptability of the intervention for this population. Larger confirmative trials are required to form more robust conclusions.
PubMed: 32284817
DOI: 10.1080/20008198.2019.1711349 -
Schizophrenia Research Jul 2020Sleep disturbance is a common clinical issue for patients with psychosis. It has been identified as a putative causal factor in the onset and persistence of psychotic... (Review)
Review
BACKGROUND
Sleep disturbance is a common clinical issue for patients with psychosis. It has been identified as a putative causal factor in the onset and persistence of psychotic experiences (paranoia and hallucinations). Hence sleep disruption may be a potential treatment target to prevent the onset of psychosis and reduce persistent psychotic experiences. The aim of this review is to describe developments in understanding the nature, causal role, and treatment of sleep disruption in psychosis.
METHOD
A systematic literature search was conducted to identify studies, published in the last five years, investigating subjective sleep disruption and psychotic experiences.
RESULTS
Fifty-eight papers were identified: 37 clinical and 21 non-clinical studies. The studies were correlational (n = 38; 20 clinical, 18 non-clinical), treatment (n = 7; 1 non-clinical), qualitative accounts (n = 6 clinical), prevalence estimates (n = 5 clinical), and experimental tests (n = 2 non-clinical). Insomnia (50%) and nightmare disorder (48%) are the most prevalent sleep problems found in patients. Sleep disruption predicts the onset and persistence of psychotic experiences such as paranoia and hallucinations, with negative affect identified as a partial mediator of this relationship. Patients recognise the detrimental effects of disrupted sleep and are keen for treatment. All psychological intervention studies reported large effect size improvements in sleep and there may be modest resultant improvements in psychotic experiences.
CONCLUSIONS
Sleep disruption is a treatable clinical problem in patients with psychosis. It is important to treat in its own right but may also lessen psychotic experiences. Research is required on how this knowledge can be implemented in clinical services.
Topics: Delusions; Hallucinations; Humans; Paranoid Disorders; Psychotic Disorders; Schizophrenia; Sleep
PubMed: 31831262
DOI: 10.1016/j.schres.2019.11.014 -
Journal of the Academy of... 2024Othello syndrome (OS) is a condition characterized by a delusion of jealousy that one's spouse is having extramarital affairs. As in the eponymous Shakespearean tragedy,... (Review)
Review
BACKGROUND
Othello syndrome (OS) is a condition characterized by a delusion of jealousy that one's spouse is having extramarital affairs. As in the eponymous Shakespearean tragedy, there is an unfortunate risk of violence. For patients with these symptoms, consultation-liaison psychiatrists may be asked to assist with evaluating the differential diagnosis, assessing safety, and developing treatment options.
OBJECTIVE
This study's objective was to solidify current knowledge of the clinical presentations and management of OS through a systematic review of the literature and description of 2 new cases.
METHODS
We conducted a literature search from the start of relevant databases through August 2023 to identify English language case reports of adults (≥18 years) with OS that described clinical evaluations, biological treatments, and outcomes. We extracted demographics, proposed etiologies, treatment choices and responses, duration of delusions, comorbid psychiatric symptoms, neuro-radiographic findings, and presence of physical violence. We reported clinical findings for 2 new cases.
RESULTS
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we screened 705 abstracts and conducted full-text reviews of 118 articles to identify 73 cases published from 1983 to 2023 meeting inclusion criteria. The mean age was 58.2 years with male predominance (M:F = 1.88). Etiologies included primary psychiatric disorders (16, 22%), other medical conditions (38, 52%), and medications or other substances (19, 26%). Delusional disorder, cerebrovascular accident, and dopaminergic agonists were the most common etiologies, respectively, in these groups. Antipsychotics were the most common treatment (57, 78%). Symptom remission was reported in 51 (70%) cases. The average duration of OS was 39.5 months. Of 32 cases reporting brain imaging insults, 12 of 20 (60%) showed right-sided lesions, and 8 of 20 (40%) showed left-sided lesions, with 9 of 32 (28%) located in the frontal lobes. The most commonly co-existing psychiatric symptom was depression (14, 19%). Violence was reported in 25 cases (34%). Our 2 new cases were consistent with these findings.
CONCLUSIONS
OS may be a manifestation of several neuropsychiatric conditions, primarily delusional disorder, cerebrovascular accident, Alzheimer's dementia, and the use of dopaminergic agonists. One-third of cases include violent behaviors. It appears to respond to antipsychotic medications, but treatment is delayed more than 3 years on average. Available data have not localized OS to a specific brain region.
Topics: Adult; Humans; Male; Middle Aged; Female; Schizophrenia, Paranoid; Delusions; Dopamine Agonists; Antipsychotic Agents; Stroke
PubMed: 37832650
DOI: 10.1016/j.jaclp.2023.09.006 -
Social Psychiatry and Psychiatric... Jul 2016In the last decade researchers have embraced virtual reality to explore the psychological processes and mechanisms that are involved in the onset and maintenance of... (Review)
Review
PURPOSE
In the last decade researchers have embraced virtual reality to explore the psychological processes and mechanisms that are involved in the onset and maintenance of psychosis. A systematic review was conducted to synthesise the evidence of using virtual reality to investigate these mechanisms.
METHODS
Web of Science, PsycINFO, Embase, and Medline were searched. Reference lists of collected papers were also visually inspected to locate any relevant cited journal articles. In total 6001 articles were potentially eligible for inclusion; of these, 16 studies were included in the review.
RESULTS
The review identified studies investigating the effect of interpersonal sensitivity, childhood bullying victimisation, physical assault, perceived ethnic discrimination, social defeat, population density and ethnic density on the real-time appraisal of VR social situations. Further studies demonstrated the potential of VR to investigate paranoid ideation, anomalous experiences, self-confidence, self-comparison, physiological activation and behavioural response.
CONCLUSIONS
The reviewed studies suggest that VR can be used to investigate psychological processes and mechanisms associated with psychosis. Implications for further experimental research, as well as for assessment and clinical practise are discussed. The present review has been registered in the PROSPERO register: CRD42016038085.
Topics: Humans; Psychotic Disorders; User-Computer Interface; Virtual Reality Exposure Therapy
PubMed: 27262562
DOI: 10.1007/s00127-016-1245-0 -
International Journal of Environmental... Nov 2017To evaluate the effects of group counseling programs, cognitive behavioral therapy (CBT), and sports intervention on Internet addiction (IA), a systematic search in ten... (Meta-Analysis)
Meta-Analysis Review
To evaluate the effects of group counseling programs, cognitive behavioral therapy (CBT), and sports intervention on Internet addiction (IA), a systematic search in ten databases was performed to identify eligible studies without language restrictions up to January 2017. A meta-analysis and trial sequential analysis (TSA) was performed, respectively. A total of 58 randomized controlled trials (RCTs), which included 2871 participants, were incorporated into our meta-analysis. The results showed that group counseling programs, CBT, and sports intervention could significantly reduce IA levels (group counseling program: standardized mean difference (SMD), -1.37; 95% confidence interval (CI), -1.89 to -0.85; CBT: SMD, -1.88; 95% CI, -2.53 to -1.23; sports intervention: SMD, -1.70; 95% CI, -2.14 to -1.26). For group counseling programs, this treatment was more effective in four dimensions of IA, including time management, interpersonal and health issues, tolerance, and compulsive Internet use. For CBT, this treatment yielded a positive change in depression, anxiousness, aggressiveness, somatization, social insecurity, phobic anxiety, paranoid ideation, and psychoticism. For sports intervention, the significant effects were also observed in all dimensions of the IA scale. Each of group counseling programs, cognitive behavioral therapy, and sports intervention had a significant effect on IA and psychopathological symptoms. Sports intervention could improve withdrawal symptoms especially.
Topics: Adult; Anxiety Disorders; Behavior, Addictive; China; Cognitive Behavioral Therapy; Counseling; Depressive Disorder; Female; Humans; Internet; Republic of Korea; Sports; Students
PubMed: 29182549
DOI: 10.3390/ijerph14121470 -
Substance Abuse 2017Cannabis is the most widely used illicit drug in the United States and Europe. In recent years, a range of new substances with cannabis-like effects-known as synthetic... (Review)
Review
BACKGROUND
Cannabis is the most widely used illicit drug in the United States and Europe. In recent years, a range of new substances with cannabis-like effects-known as synthetic cannabinoids (SCs)-have suddenly burst on the drug scene. However, there is limited information about the clinical hazards linked to the use of these emerging substances. This review summarizes the literature to date relating the health effects of SCs.
METHOD
A systematic literature review of original case studies was performed using PubMed and Web of Science (January 1980-July 2015). Only articles in which a drug screening was reported were included in this review.
RESULTS
Forty-six articles meeting the inclusion criteria were included in this review, reporting data on 114 patients who went to hospital emergency departments after exposure to SCs. The majority of patients were adolescent or young adult males (14-25 years; 24.5 ± 10.1 years). The most common route of administration was smoking. The SCs most involved were John William Huffman (JWH) derivatives, followed by XRL-11, ADB-PINACA, AM-2201, MAM-2201, and 5F-PB-22. This analysis showed that the use of these substances may cause minor and moderate side effects similar to those of cannabis intoxication, including tachycardia, nausea, somnolence, hallucinations, paranoia, xerostomia, and injected conjunctivae among others. However, atypical cannabis intoxication effects and worse complications (such as renal injuries, aggressiveness, cerebral ischemia, myocardial infarction, etc.) were also observed, which led to a significant morbidity were also observed. Some SCs were highlighted as being involved in 24 cases of deaths.
CONCLUSIONS
In this review, the nature and frequency of the signs and symptoms of SC poisoning were estimated in order to inform health professionals about the health risks of these new and emerging substances.
Topics: Cannabinoids; Humans
PubMed: 27715709
DOI: 10.1080/08897077.2016.1219438